Smoke-Free Laws and Direct Democracy Initiatives on

Transcription

Smoke-Free Laws and Direct Democracy Initiatives on
Int. J. Environ. Res. Public Health 2014, 11, 685-700; doi:10.3390/ijerph110100685
OPEN ACCESS
International Journal of
Environmental Research and
Public Health
ISSN 1660-4601
www.mdpi.com/journal/ijerph
Review
Smoke-Free Laws and Direct Democracy Initiatives on
Smoking Bans in Germany: A Systematic Review and
Quantitative Assessment
Stefan Kohler * and Philipp Minkner
Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center,
Berlin 10117, Germany; E-Mail: [email protected]
* Author to whom correspondence should be addressed; E-Mail: [email protected];
Tel.: +49-30-450-529-002; Fax: +49-30-450-529-902.
Received: 9 October 2013; in revised form: 19 December 2013 / Accepted: 20 December 2013 /
Published: 3 January 2014
Abstract: Background: Germany’s 16 states regulate smoking differently within health
protection principles laid down in the federal law. All state smoke-free laws in Germany
have undergone at least one change since taking effect. Methods: We systematically review
federal and state laws regulating smoking, as well as petitions, popular initiatives and
referenda that aimed at changing statutory smoking bans. Data generated through the
systematic review were correlated with state smoking rates. Results: The protection from
the dangers of secondhand smoke is the primary motive for smoking bans in Germany.
The first smoke-free laws affecting smoking in pubs, restaurants and several other public
places were introduced in 2007. In 2008, the Federal Constitutional Court of Germany
ruled in a leading decision on the smoke-free laws of two states that some common
smoking ban exemptions of the introduced smoke-free laws violate the basic right to freely
exercise a profession and mandated revisions. All states but Bavaria and Saarland,
whose smoking bans were more and less comprehensive than those judged by the
constitutional court, respectively, needed to change the smoking ban exemptions to
reconcile their smoke-free laws with the constitution. Direct democracy initiatives to
change smoking bans were only successful in Bavaria in 2010, but a total of 15 initiatives
by citizens’ or interest groups attempted to influence non-smokers protection legislation
through direct democratic procedures. Early ratification of a smoking ban in a federal
state correlates with a higher reduction in the smoking rate from 2005 to 2009 (Spearman’s
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ρ = 0.51, p = 0.04). Conclusions: The federal government structure and direct democratic
participation in smoke-free legislation in Germany has produced a diversity of local smoking
bans and exemptions.
Keywords: anti-smoking law; court decision; Germany; petition; popular initiative;
referendum; smoking ban; smoke-free law; smoking prevalence; tobacco control
1. Introduction
More than 3,300 people are estimated to die annually from secondhand tobacco smoke in Germany [1].
According to a 2009 addiction survey, the highest exposure of non-smokers to secondhand smoke is at
the workplace and during non-domestic leisure activities [2]. A percent of 47.4 of females and
36 percent of males in Germany feel strongly disturbed by tobacco smoke [3]. Tobacco smoke contains
about 4,800 chemicals. Of these, about 200 are toxic and about 50 are classified as carcinogenic [4,5].
The harmful substances contained, such as benzene, formaldehyde and nitrosamines, affect the active
consumers of tobacco and people who passively inhale tobacco smoke.
Several countries have banned smoking in public places to protect non-smokers from secondhand
tobacco smoke. Germany has ratified the WHO Framework Convention on Tobacco Control (FCTC)
on 12 December 2004. The FCTC was developed in response to the globalization of the tobacco
epidemic. Its signatories assumed an obligation to reduce the demand for and the supply of tobacco,
and its eighth article on the protection from exposure to tobacco smoke explicitly states:
“(1) Parties recognize that scientific evidence has unequivocally established that exposure to tobacco
smoke causes death, disease and disability; (2) Each Party shall adopt and implement in areas of
existing national jurisdiction as determined by national law and actively promote at other jurisdictional
levels the adoption and implementation of effective legislative, executive, administrative and/or other
measures, providing for protection from exposure to tobacco smoke in indoor workplaces,
public transport, indoor public places and, as appropriate, other public places” [6].
The extent and strictness of smoking bans differ within Germany. Each of the 16 federal states of
Germany has a different set of regulations for non-smokers protection. The Association of European
Cancer Leagues published studies on the effectiveness of political measures against tobacco smoking.
Germany ranked 27 out of 30 European countries compared in 2007 and was called the most
problematic country in reference to tobacco control [7]. In 2010, Germany ranked 26 out of 31
compared European countries [8]. In this article, firstly, we review the smoke-free laws of Germany
and present fundamental court decisions with regard to smoking. Secondly, we compare the regulation
of smoking in pubs and restaurants, as the most debated public places in which smoking has become
regulated by law, across states. Thirdly, we review the direct democratic activities around smoking
bans in Germany and discuss how citizens and interest groups influenced the legislative process on
non-smokers protection.
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2. Materials and Methods
Federal law in Germany is only effective if announced in the Federal Law Gazette
(Bundesgesetzblatt). The federal states of Germany announce their laws and ordinances in a
Law and Ordinance Gazette (Gesetz- und Verordnungsblatt). In the state of Saarland an
Official Gazette (Amtsblatt) fulfills this function. We searched the respective gazettes of the federal
republic and all 16 federal states for announcements of smoke-free laws through the Beck-Online law
database [9]. Officially announced changes of the smoke-free laws were considered at least until
28 June 2013 and at most until 27 November 2013 (supplementary Table S1). We reviewed the full
texts of the federal non-smokers protection laws [10,11] as well as the first and most recent versions of
the state smoke-free laws [12–28]. Full texts of the smoke-free laws and amendments were accessed
through an open access archive for the federal and state law gazettes, called Parlamentsspiegel [29].
Smoke-free laws and further information about tobacco control are also available through the website
of the Aktionsbündnis Nichtrauchen e. V. (Action Alliance for Non-smoking), an alliance of major
German health NGOs [30]. Additional information was used to assess if private functions in a pub or
restaurant can be exempted from a smoking ban [31–34].
Petitions, popular initiatives and referendums on non-smokers protection were extracted from the
referendum reports for the years 2000 to 2012 [35,36]. The referendum report is a publication by
Mehr Demokratie e. V. (More Democracy), a German NGO for direct democracy that annually reports
on direct democratic activities in Germany since 2000. In addition, all state websites were screened for
data on petitions, popular initiatives and referendums on non-smokers protection.
In a correlation analysis, data generated through the systematic review were combined with
disaggregated data on smoking rates. Data on the effective date of the first federal non-smokers
protection laws in Germany and fines for breaches of these laws were extracted from the reviewed
federal state laws and the federal Administrative Offence Act (Ordnungswidrigkeitengesetz) [37].
Smoking rates in the federal states of Germany stem from 2005 and 2009 microcensus data.
The microcensus is an annual representative household survey of one percent of the German
population (340,000 households with approximately 700,000 persons in 2009) that usually asks about
smoking habits every four years. Only persons aged 15 years and above were asked five questions
about their smoking habits, including the current smoking status. Answering these microcensus
questions is voluntary. We compare the 2005 and 2009 smoking rates reported in the microcensus that
are age-standardized to the year 1987 German population [38].
3. Results and Discussion
3.1. Federal Non-smokers Protection
The protection from the dangers of secondhand smoke is the primary motive for smoking bans in
Germany. On 9 February 1998, before there were statutory smoking bans in Germany, the Federal
Constitutional Court (Bundesverfassungsgericht (BVerfG)) did not accept a constitutional complaint
in which the complainant felt violated in his fundamental rights to physical integrity and free
development of personality by smoking in places open to the public (BVerfG, 1 BvR 2234/97).
On 1 September 2007, the Law for Protection from the Hazards of Passive Smoking came into force in
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the Federal Republic of Germany [11]. This law included various changes of and amendments to the
existing legislation and an article imposing a ban on smoking in federal facilities and public transport,
named the Law for the Introduction of a Smoking Ban in Federal Facilities and Public Transport
(Federal Non-smokers Protection Act) [10].
The Federal Non-smokers Protection Act of the Law for Protection from the Hazards of Passive
Smoking governs two essential aspects: Firstly, it prohibits smoking in federal facilities as well as in
the constitutional bodies of the federation, e.g., government agencies, courts, or federal corporations,
institutions and foundations. These institutions, however, were allowed to establish designated smoking
zones where tobacco may be consumed. Secondly, the law banned smoking from all modes of public
transport (planes, trains, buses, trams, taxis, and passenger ships) and in all train station buildings.
If space allows, smoking can be permitted in designated and appropriately marked areas of the train
stations. The German Railway extended the statutory smoking ban in their house rules from station
buildings to the entire station area with the exemption of designated smoking areas [39]. The federal
Law for Protection from the Hazards of Passive Smoking also changed the Youth Protection Act
(Jugendschutzgesetz) [40]. Firstly, the age limit for the purchase of tobacco products has been increased
from 16 to 18 years. Secondly, children and young people (below the age of 18) were not to be allowed
to smoke in public (§ 10 Jugendschutzgesetz). Furthermore, the federal Workplace Regulations
(Arbeitsstättenverordnung) were modified by the Law for Protection from the Hazards of Passive
Smoking. The following sentence was added: The employer shall ban smoking in all or specific areas
of the workplace to the extent necessary to effectively protect non-smoking employees from the health
hazards of tobacco smoke (§ 5 Abs. 1 Satz 2 (§ 5 subsection 1 sentence 2) Arbeitsstättenverordnung).
Workplaces open to the public (and therefore pubs and restaurants) remained excluded from this strict
federal regulation and only required to ban smoking to the extent compatible with the nature of the
business or type of employment (§ 5 Abs. 2 Arbeitsstättenverordnung) [41].
In addition to the Law for Protection from the Hazards of Passive Smoking, other regulations
prohibit smoking. There were different approaches to protect non-smokers in the gastronomy sector.
In 2005, a non-binding agreement between the Federal Ministry of Health and the German Hotel and
Restaurant Association was signed which did not lead to the desired improvement in non-smokers
protection [42]. In fact, the federal government declared that it lacked the legislative competence in
this area and, since 2007, the non-smokers protection in the gastronomy sector has been regulated by
state laws.
Smoking is generally permitted in rented apartments (District Court (Landgericht) Cologne, 9 S 188/98;
District Court (Landgericht) Paderborn, 1 S 2/00). If the odor caused by smoking cannot be eliminated
by a single airing, then damage compensation can be claimed (District Court (Amtsgericht) Rosenheim,
16 C 1946/93). The landlord may ban smoking in the stairwell (District Court (Amtsgericht) Hannover,
70 II 414/99). Odor trouble caused by passive smoking that occurs during short stays in the stairwell or
elevator must be accepted (Labor Court (Arbeitsgericht) Munich, 2 Z BR 105/98). Tenants are entitled
to reduce their rent if, due to the design of the house, tobacco smoke from another apartment enters
their own apartment and, thus, imposes a health risk or unpleasant odor (District Court (Amtsgericht)
Stuttgart-Bad Cannstatt, 6 C 1711/97).
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Table 1. Smoke-free laws, smoking bans and exemptions for pubs and restaurants,
and smoking rates in the federal states of Germany.
Federal
Code Effective
State
Date
Changes
Last
Expiry
Fine (€)
# Date
Pubs and
Smoking
% Change
Restaurants
Rate 2009
since 2005
24.4
−5.1
25.6
0.0
Ban
a,b,d
32.1
−2.7
Ban
a,b
30.7
−1.6
a,b
32.1
−4.2
27.5
−10.4
Ban
a,bc
26.5
−3.3
Ban
a,b
33.9
−5.6
a,b
28.0
−5.7
28.5
−5.6
Ban
a,b,c
27.4
−0.4
Ban
c
27.2
−3.5
a,b,c
a,b
Baden-Wuerttemberg
BW
01.08.07
03.03.09
1 None
≤40/2,500
Ban
Bavaria
BY
01.01.08
23.07.10
3 None
(5–1,000)
Ban c
Berlin
BE
Brandenburg
BB
01.01.08
01.01.08
03.06.10
15.07.10
3 None
2 None
≤100/1,000
5–100/10–1,000
Bremen
HB
01.01.08
25.06.13
4 31.07.18
≤500/2,500
Ban
Hamburg
HH
01.01.08
19.06.12
3 None
20–200/50–500
Ban a,b
Hesse
HE
M.-W. Pomerania
MV
01.10.07
01.08.07
27.09.12
17.12.09
3 31.12.20
1 31.07.14
≤200/2,500
≤500/10,000
Lower Saxony
NI
01.08.07
10.12.08
1 None
(5–1,000)
Ban
N. Rhine-Westphalia
NW
01.01.08
04.12.12
2 None
≤2,500
Ban c
Rhineland-Palatinate
Saarland
RP
SL
15.02.08
15.02.08
26.05.09
21.06.10
1 None
5 31.12.15
≤500/1,000
≤200/1,000
Saxony
SN
01.02.08
01.07.12
4 None
≤5,000
Ban
27.3
0.0
Saxony-Anhalt
SA
01.01.08
23.01.13
4 None
(5–1,000)
Ban a,b
32.9
6.5
Ban
a,b
29.0
−7.3
Ban
a,b
30.3
2.0
Schleswig-Holstein
Thuringia
SH
TH
01.01.08
01.07.08
25.04.09
31.12.12
1 None
2 None
≤1,000
20–200/50–500
Notes: Dates are denoted in the format date month year. Changes denote the announcement date of the last change to the
smoke-free law and the total number of changes made since the effective date (see supplementary Table S1). Fine denotes
fines established in the smoke-free law that can be imposed for minor breaches of the law by violating/not enforcing ban.
Parentheses indicate that the amount of the fine is regulated in the § 17 Administrative Offence Act
(Ordnungswidrigkeitengesetz). Superscripts denote smoking ban exemptions for pubs and restaurants: a Separate rooms;
b
Smoking pub; c Smoking can be permitted while hosting a private function (geschlossene Gesellschaft); d Operated and
visibly labeled as shisha lounge in which no alcoholic beverages are served. %-Change denotes the change in the
age-standardized smoking rate from 2005 to 2009 as a percentage of the baseline year 2005. The HB non-smokers
protection act replaced an earlier law from 18.07.06 that partially banned smoking in hospitals, daycare for children,
and schools. The last change in BY replaced the non-smokers protection act completely after a referendum. Repeated offenders
can face higher fines in BW (≤ 150/5,000) and SL (≤ 200/2,000) or lose the concession to operate a gastronomic facility
in SL. Only the smoke-free laws of HE, RP and SN explicitly enumerate a noncommercial private function as an
exemption to the smoking ban in pubs and restaurants. In BY, the state constitutional court ruled that the statutory
smoking ban does not apply to true private functions. In NW, the smoke-free law does not apply to premises used
privately. The government of SL informs that the smoke-free law does not apply to true private functions hosted in a pub
or restaurant because, from a legal point of view, no gastronomic facility is operating for the limited time of the private
function. Source: Own compilation based on state smoke-free laws [12–28], 2005 and 2009 microcensus data [38],
and supplementary information [9,31–34,37].
3.2. State Non-smoker Protection
Starting in 2007, each of the 16 federal states in Germany introduced a state law for the protection
of non-smokers. By 1 July 2008, smoke-free laws were ratified in all federal states, but smoking
became prohibited to a different extent in public places across states (Table 1). Smoking in pubs and
restaurants, for instance, is banned throughout Germany. In most states, however, there are exemptions
from the ban that allow smoking in separate rooms and in so-called smoking pubs that operate in less
than 75 m2 and only admit people over 18 years old. Additional restrictions on the type of food that can
be severed in smoking pubs may also apply. Strict no-smoking policies without exemption during
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public events in pubs and restaurants exist only in Bavaria, Saarland, and since 1 May 2013 also in
North Rhine-Westphalia.
On 30 July 2008, the Federal Constitutional Court announced the leading decision that some of the
just introduced smoking bans and their exemptions constitute a violation of the fundamental right to
freely exercise a profession: Firstly, small gastronomic facilities, e.g., corner pubs (Eckkneipen),
that focus on selling drinks and operate in one room, in which smoking is banned, are put at an
economic disadvantage through the smoke-free law if larger gastronomic facilities are allowed to permit
smoking in a separate room. Secondly, nightclubs are unduly disadvantaged if the smoke-free law allows
gastronomic facilities but not nightclubs to establish separate smoking rooms. New undiscriminating
regulations were to be issued by 31 December 2009 (BVerfG, 1 BvR 3262/07, 402/08, 906/08).
This ruling occurred after two innkeepers and a nightclub operator had filed constitutional complaints
against the non-smokers protection laws of Berlin and Baden-Wuerttemberg, respectively. The Federal
Constitutional Court declared the concerned clauses of the smoke-free laws in these two states
incompatible with the constitution and mandated to either eliminate or extend smoking ban exemptions
in a manner that does not discriminate nightclubs or small gastronomic facilities. The objected
smoke-free laws remained valid until revised within the transition period, but small gastronomic
facilities in Baden-Wuerttemberg and Berlin could immediately readmit smoking if no food was
prepared and sold on the premises, size was below 75 m2, no separate side-room existed,
and minors were not admitted. In addition, a sign in the entrance area had to indicate that smoking is
allowed and entry of minors is prohibited. Nightclubs in Baden-Wuerttemberg could immediately
allow smoking in separate rooms without a dance floor if access was for adults only.
Formally, the ruling applied only to Berlin and Baden-Wuerttemberg, but other states were
indirectly affected because their smoke-free laws included exemptions similar to the clauses of the two
smoke-free laws ruled unconstitutional. In the opinion of the court, at this particular time, only the states
of Bavaria and Saarland did regulate non-smokers protection conform to the German constitution.
The Bavarian smoke-free law imposed stricter bans without exemptions for publicly accessible pubs
and restaurants, and it did not list separate regulations for nightclubs. The smoke-free law of Saarland
allowed the smoking ban exemptions of separate rooms and of owner-operated gastronomic facilities
(inhabergeführte Gaststätte), and it allowed also nightclubs to permit smoking in separate rooms
without a dance floor.
After this leading decision of the Federal Constitutional Court on two state smoke-free laws,
most German states readmitted smoking under certain conditions in small gastronomic facilities that
operated in one room only. The House of Representatives of Berlin, for instance, adopted the
First Amendment to its Non-smokers Protection Act on 14 May 2009 [43]. So-called smoking pubs
(Rauchergastätten), in which smoking was allowed, could be created in consequence. Primarily in
Bavaria, in which the initial smoke-free law had completely ruled out smoking in all pubs another
option was pursued. Smoking clubs (Raucherclubs) that required membership were formed because the
initial smoke-free law of Bavaria did not ban smoking when a pub hosted a private function
(geschlossene Gesellschaft). An amendment to the Bavarian smoke-free law from 27 July 2009,
which was effective until 31 July 2010, eliminated the smoking club exemption and admitted
smoking pubs and smoking in separate rooms [44]. A constitutional complaint against the smoke-free
law of Bavaria was not accepted by the Federal Constitutional Court on 10 September 2009 after this
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amendment (BVerfG, 1 BvR 2054/09). On 31 January 2012, the Bavarian Constitutional Court ruled
that the inclusion of smoking clubs in the smoking ban for pubs and restaurants was in line with the
constitution [14], but that smoking can be admitted in true private functions (echte geschlossene
Gesellschaften) (VerfGH Bayern, Vf. 26-VII-10). A true private function was characterized by the
Bavarian Administrative Court as a gathering that is limited from the outset to a usually small number
of personally invited individuals who are already known before the event, e.g., a private family
celebration (VGH Bayern, 24 January 2011, 10 CS 11.2).
A further successful constitutional complaint against statutory smoking bans affected the state
smoke-free law of Hamburg on 24 January 2012 (BVerfG, 1 BvL 21/11). The complaint objected to a
discrimination among gastronomic facilities in Hamburg, where pubs (that focus on selling drinks)
under certain conditions could permit smoking, but restaurants (that focus on selling food) could not.
The state of Hamburg revised its non-smokers protection law accordingly and eliminated the condition that
smoking could be allowed in separate rooms only if no food was prepared in the gastronomic facility.
Although the focus of the public debate lies on smoking bans for pubs and restaurants
(including cafes and snack bars), the smoke-free laws of the German states regulate smoking in further
public places including nightclubs, cultural venues, schools, youth and daycare centers, hospitals,
universities, sport centers, shopping malls, or state airports, courts and prisons. Notwithstanding how
comprehensively a state banned smoking, neither the maximum fine that can be imposed for violations
of a smoking ban nor the maximum fine that can be imposed for not enforcing the state smoke-free law
correlates with a higher reduction in smoking (Spearman’s ρ = −0.01, p = 0.99 and Spearman’s
ρ = −0.14, p = 0.61; Figure 1a). By contrast, an early effective date of smoking bans correlates with a
higher percentage decrease in the smoking prevalence from 2005 to 2009 (Spearman’s ρ = 0.51,
p = 0.04; Figure 1b). The latter correlation could be explained, for instance, by a delayed effect of later
smoking bans on smoking behavior. It could also be accounted for by alternative explanations.
We discuss two plausible alternative causes and arguments against them. Firstly, it is possible that
those states with a higher reduction in smoking were more successful in implementing smoke-free
laws early because of advantageous initial conditions affecting both. The past smoking rate of the state
could be such an initial condition, but the 2005 smoking rates (implicitly reported in Table 1) appear to
correlate neither with the effective dates of the first smoke-free laws (Spearman’s ρ = −0.15, p = 0.58)
nor with the percentage change in the smoking rate from 2005 to 2009 across states (Spearman’s
ρ = −0.31, p = 0.24). Secondly, the correlation between the change in the smoking rate and the
ratification date of the first state smoke-free law could be due to generally more comprehensive
tobacco control in the states adopting smoking bans early. However, we are not aware of other
significant differences between states with regards to tobacco control activities apart from the state
smoke-free legislation in Germany. An in depth investigation of the causal relationship underlying the
observation that an early effective date of smoking bans is associated with a higher reduction in
smoking in Germany is outside the scope of this article.
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Figure 1. Maximum fine for a breach of the smoke-free law, effective date of the smokefree law and change in smoking rate in German states.
Notes: The dashed line indicates the national average change in the smoking rate from 2005 to 2009 as a
percentage of the baseline year 2005. (a) Spearman’s rank correlation coefficient ρ = −0.14 (p = 0.61).
(b) Spearman’s rank correlation coefficient ρ = 0.51 (p = 0.04). Source: Own computation based on Table 1.
3.3. Petitions, Popular Initiatives and Referendums on Non-smokers Protection
In addition to the top-down legislation and the legal action of individuals, numerous initiatives by
citizens’ or interest groups attempted to influence non-smokers protection legislation through the direct
democratic procedures available in Germany. All of Germany’s state constitutions offer a referendum
and some also a petition as instruments by which the citizens of the state can directly influence the
democratic decision-making process. There are differences between states, but most states follow a
three-stage process for the referendum. The referendum is preceded by a popular initiative,
which needs to be preceded by a motion. A state parliament may debate an issue that passed through a
motion or hear its initiators. A popular initiative has a higher quorum than a motion. If the quorum of
the popular initiative is passed, it results in a referendum. A petition is different from a motion for a
popular initiative. It is nonbinding and solely leads to a discussion of the matter in the state parliament
if successful [45].
Initiatives on the issue of smoking in public places have been formed by individuals or interest groups
in order to directly influence the smoke-free legislation (Table 2). The objectives of the various
initiatives in favor of non-smokers protection in Germany were similar. They asked for a smoke-free
environment that includes restaurants, bars and pubs, cafes, discos and clubs, playgrounds, and other
shared spaces. Counterinitiatives rejected comprehensive smoking bans that provide few or no
exemptions. So far, there have been 15 direct democracy initiatives leading to two petitions, 13 motions
for a popular initiative, two popular initiatives and one referendum on non-smokers protection in
Germany, all of which included the regulation of smoking in pubs and restaurants. Four initiatives were
in favor of more comprehensive non-smokers protection in public places, and 11 initiatives against it.
Seven of the 11 initiatives rejecting comprehensive smoking bans were initiated by one and the
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same initiators, The Doers Society (Die Macher e. V.), a registered association offering assistance with
direct democratic procedures.
Table 2. Petitions, popular initiatives and referenda on non-smokers protection in Germany.
Federal
State
Title or Aim of
Direct Democracy
Initiators
Stage
Initiative
Start–
Signatories
Formal Success
End
(Quorum)
(Factual Success)
04.07.10
—
19.11.09–
1,300,000
02.12.09
(940,000)
01. 05.09–
40,300
17.07.09
(25,000)
61% Approval rate
Action alliance of
political parties, doctors,
Bavaria
For real non-smokers
smoke-free society and
protection (Für echten
others (Aktionsbündnis:
Nichtraucherschutz)
ödp, Pro Rauchfrei e. V.,
Ärzte, SPD, Bündnis
90/Die Grünen, andere)
3
law [14])
2
1
Against the non-smokers
26.01.08–
protection law (Gegen das
Nichtraucherschutzgesetz)
Brandenburg
1
January
The doers society
2010
(Die Macher e.V)
16.01.08–
Free smokers (Freie Raucher)
(New smoke-free
1
November
7,450
(25,000)
Yes
Yes a
Ceased
100 (20,000) Ceased
2008
Smoke-free societies and
Fresh air for Berlin (Frische
Luft für Berlin)
others (Forum Rauchfrei,
Nichtraucherbund Berlin- 1
Brandenburg e. V., Pro
24.09.10–
23,633
14.04.11
(20,000)
26.01.09–
61,644
25.05.09
(171,000)
11.11.07–
23,252
30.04.08
(20,000)
05.07.10–
<10,000
05.01.11
(10,000)
07.09.07–
11,000
08.12.07
(10,000)
Yes (No) b,c
Rauchfrei e. V., andere)
Berlin
No smoking ban in pubs and
restaurants in Berlin
(Wahlfreiheit für Gäste und
Wirte—kein Rauchverbot in
Berliner Gaststätten)
For true non-smokers
protection—without
exemptions (Für echten
Nichtraucherschutz—
ohne Ausnahmen)
Hamburg
Action alliance “Initiative
for Consumption”—
2
No
innkeepers
(Aktionsbündnis
“Initiative für Genuss”—
1
Yes
Kneipen und Gastwirte)
Alliance of political party
and smoke-free society
(ödp, Nichtraucherschutz
1
No
Hamburg e. V.)
Initiative “Smoking
Against the non-smokers
protection law (Gegen das
Nichtraucherschutzgesetz)
Rebels Hamburg”—
individual innkeepers
(Initiative “Hamburger
1
Yes (No) d
Rauchrebellen”—
einzelne Gastwirte)
Against the revision of
Hesse
smoking bans (Gegen die
The doers society
Neuregelungen zum
(Die Macher e. V.)
Rauchverbot)
10.12.07–
1
February
2010
>50,000
(130,000)
Ceased a
Int. J. Environ. Res. Public Health 2014, 11
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Table 2. Cont.
Title or Aim of
Federal
Direct Democracy
State
Initiators
Stage
Initiative
Reform non-smokers
Hotel and restaurant
protection law—
association lower saxony
Lower Saxony for exemptions (Reform
Nichtraucherschutzgesetz—
Gaststättenverband
für Ausnahmeregelungen)
Niedersachsen)
For better non-smokers
protection (Für verbesserten
North RhineWestphalia
(Hotel-und
Nichtraucherschutz)
1
pharmacists and others
(Aktionsbündnis:
1
1
Nichtraucherschutzgesetz)
Rhineland-
1
The doers society
Legalize smoking
SchleswigHolstein
Thuringia
(Legalisierung von Rauchen)
Formal Success
End
(Quorum)
(Factual Success)
26.11.07–
66,210
25.11.08
(70,000)
29.01.07–
Not
21.12.07
available
25.01.08–
30
15.06.09
(3,000)
07.02.08–
5,500
31.12.08
(20,000)
07.02.08–
50
15.06.09
(5,000)
01.01.08–
8,150
15.06.09
(20,000)
01.01.08–
800
15.06.09
(5,000)
No b
Ceased e
Apotheken und andere)
protection law (Gegen das
Saarland
Signatories
Action alliance of
Against the non-smokers
Palatinate
Start–
(Die Macher e.V)
1
1
1
Ceased f
Ceased
Ceased
Ceased
Ceased
Notes: Dates are denoted in the format date month year. Dashed lines separate different stages of one initiative.
Solid lines separate different initiatives. Numbers denote the stage of the initiative: 1 motion for a popular initiative
(Volksinitiative bzw. Antrag auf Volksbegehren) or petition if indicated by superscript; 2 popular initiative
(Volksbegehren); 3 referendum (Volksentscheid). Superscripts denote remarks:
a
signatories by end of the year;
b
nonbinding petition that can solely lead to a discussion of the matter in the state parliament (Volkspetition);
c
state parliament rejected the petition; d referendum not requested; e state parliament ratified a non-smokers protection act
on 19 December 2007; f Federal Constitutional Court requested a revision of smoking bans on 30 July 2010. No direct
democracy initiatives on non-smokers protection took place in BW, HB, MV, NI or SN since 2000. Source: Own
compilation based on state websites and referendum reports 2000–2012 [35,36].
Two waves of initiatives can be distinguished. Twelve initiatives started in 2007 through early 2008,
around the time when the first state smoking bans took effect in Germany. All of those but one
opposed smoking bans. One motion against the introduction of smoking bans in pubs and restaurants in
Berlin was successful. It lead to the next level of a popular initiative, but it then failed the quorum.
All other initiatives failed because the motion or petition was either ceased, stopped, rejected,
unsuccessful, or resolved by the ratification of a non-smokers protection law. The very first referendum
for better protection of non-smokers in Germany was attempted in the state of North Rhine
Westphalia. It was the initiative ceased when the state parliament approved a non-smokers protection
act on 19 December 2007.
Int. J. Environ. Res. Public Health 2014, 11
695
A second wave of three initiatives took place between 2009 and 2010, all of which aimed at
strengthening the protection from secondhand smoke through extending smoking bans. The second
wave started with a successful direct democratic change of the Bavarian smoke-free law. After 40,300
signatures had been collected in a motion in 2009, a referendum led to a plebiscite held on 4 July 2010
(Bavarian State Government, B II 2—G 58/09). The Bavarian citizens voted in favor of the suggested
stronger non-smoking bill, entitled Real Non-smokers Protection (Für echten Nichtraucherschutz),
with a majority of 61 percent and a voter turnout of 37.7 percent. In consequence, a new smoke-free
law took effect on 1 August 2010 [14]. Alike the initial Bavarian smoke-free law, it includes a strict
ban of smoking in all pubs and restaurants [13]. Thus, it eliminated the later introduced exemptions of
smoking pubs and smoking in side rooms [44]. It further eliminated a smoking ban exemption for beer
and wine pavilions, like the beer tents of the Oktoberfest, and continued to prohibit smoking during
pseudo private functions hosted in pubs and restaurants. A constitutional complaint against this strict
ban on smoking in Bavaria was rejected by the Federal Constitutional Court on 2 August 2010
(BVerfG, 1 BvR 1746/10).
The success of the direct democracy initiative in Bavaria inspired two other direct democracy
initiatives for non-smokers protection that started in Berlin and Hamburg in 2010. In contrast to the
Bavarian plebiscite, the petition Fresh Air for Berlin (Frische Luft für Berlin), which had the support
of 23,633 signatories, was dismissed in the Berlin Senate on 20 June 2011. The majority of the senate
did not see the need to strengthen the existing non-smokers protection in Berlin [46].
In Hamburg, the initiative For True Non-smokers Protection without Exemptions (Für echten
Nichtraucherschutz—ohne Ausnahmen) did not reach the quorum.
The pronounced direct democratic activity on smoking bans in Germany reflects the controversy
about smoking bans. An interesting question in this context is whether fragmented or partial smoking
bans are particularly disliked? A tentative answer to this question is suggested by two studies that
examined whether the comprehensiveness of smoke-free policies affects the support for smoking bans.
Firstly, a correlation analysis of self-reported attitudes toward smoking bans in 27 countries of the
European Union found that citizens of countries with a higher Tobacco Control Scale (TCS) score in
2007 showed higher support toward smoking bans in pubs (Spearman’s ρ = 0.50, p < 0.01),
restaurants (ρ = 0.47, p = 0.01), offices and other indoor workplaces (ρ = 0.39, p = 0.12). The correlation
between the TCS score for smoke-free public places and the support for smoking bans in pubs
(Spearman’s ρ = 0.66, p < 0.00), restaurants (ρ = 0.61, p = 0.001), offices and other indoor workplaces
(ρ = 0.46, p = 0.02) may be even stronger [47]. Secondly, a longitudinal multi-country study that
focused on the support of smoke-free policies among smokers concluded that smoke-free policies have
the potential to improve support once the policy is in place, and that this effect seems to be most
pronounced with comprehensive smoking bans [48]. In 2007 and 2010, Germany scored 37 out of a
total of 100 TCS points for its implementation of tobacco control policies, and it scored 2 and 11 out of
a total of 22 TCS points for smoke-free public places, respectively [7,8]. Hence, the limited extent of
smoking bans itself may be one of the causes of people’s demands for revisions of the smoke-free
legislation in Germany. Other factors that have been associated with attitudes toward any type of
smoking ban in Germany were smoking status, health risk ascribed to tobacco use and tobacco smoke,
and self-rated health [49].
Int. J. Environ. Res. Public Health 2014, 11
696
4. Conclusions
Non-smokers protection in the Federal Republic of Germany is governed by the federal
Law for Protection from the Hazards of Passive Smoking, which includes the Federal Non-smokers
Protection Act and amendments to previously existing laws. The explicit decision if and where a
smoking ban is imposed is up to each state parliament for public places other than federal institutions,
public transport or public train stations. Smoking bans can, and in Bavaria were, directly influenced by
the citizens through direct democratic means.
The federal government structure and direct democratic participation in non-smokers protection
legislation produced a diversity of local smoking bans and exemptions in Germany. Several studies
investigated the effect of smoking bans in Germany [50–55], but the impact of the latest amendments
by which some federal states of Germany created stricter smoke-free laws have yet to be assessed.
Acknowledgements
Stefan Kohler conceived the study. Philipp Minkner and Stefan Kohler designed and conducted the
review of German smoke-free legislation. Stefan Kohler designed and conducted the correlation
analysis and the review of direct democracy initiatives in Germany regarding smoking bans.
Stefan Kohler and Philipp Minkner wrote the manuscript.
Conflicts of Interests
The authors declare no conflict of interest.
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